Oral Inflammation, Tooth Loss, Risk Factors, and Association with Progression of Alzheimer’s Disease

Periodontitis is a polymicrobial chronic inflammatory disease of tooth-supporting tissues with bacterial etiology affecting all age groups, becoming chronic in a subgroup of older individuals. Periodontal pathogens Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola are implicated in the development of a number of inflammatory pathologies at remote organ sites, including Alzheimer’s disease (AD). The initial inflammatory hypothesis proposed that AD hallmark proteins were the main contributors of central nervous system (CNS) inflammation. This hypothesis is expanding to include the role of infections, lifestyle, and genetic and environmental factors in the pathogenesis of AD. Periodontal disease (PD) typifies a condition that encompasses all of the above factors including pathogenic bacteria. These bacteria not only are the source of low-grade, chronic infection and inflammation that follow daily episodes of bacteremia arising from everyday tasks such as brushing, flossing teeth, chewing food, and during dental procedures, but they also disseminate into the brain from closely related anatomical pathways. The long-term effect of inflammatory mediators, pathogens, and/or their virulence factors, reaching the brain systemically or otherwise would, over time, prime the brain’s own microglia in individuals who have inherent susceptibility traits. Such susceptibilities contribute to inadequate neutralization of invading agents, upon reaching the brain. This has the capacity to create a vicious cycle of sustained local inflammatory milieu resulting in the loss of cytoarchitectural integrity and vital neurons with subsequent loss of function (deterioration in memory). The possible pathways between PD and AD development are considered here, as well as environmental factors that may modulate/exacerbate AD symptoms

Oral health and rehabilitation among the institutionalized elderly

The aging and the elderly are highly associated with limitation or dependency, with some loss of capacities and the gain of conditions or age-associated pathologies. Despite advances in preventive dentistry, edentulism and oral diseases are major public health issues in Portugal, mainly among the elderly. This study investigated the oral status and level of oral rehabilitation among Portuguese institutionalized elderly. The purpose of the study was to determine the prevalence of edentulism and assess the oral rehabilitation and oral/prosthetic hygiene habits in a sample of institutionalized elderly using a cross-sectional study in a sample of 118 institutionalized elderly. Data collection was performed by applying a questionnaire about oral health behaviors and through an intraoral observation in order to determine the oral status and verify the condition of the oral rehabilitation of each participant. The findings revealed that 78.6% have a number of decayed, missing and filled teeth more than 20, 58.8% presented total edentulism (with no natural teeth in the oral cavity) and 66.7% had a removable prosthesis. Only 44.1% practiced daily oral/prosthetic hygiene at least twice a day while 29.0% and 67.7% complained of toothache and difficulty in chewing respectively. The educational level of the elderly was associated with dental pain (p=0.012) and oral/prosthetic hygiene (p=0.034). A high prevalence of tooth loss was found in the sample studied and also the need to improve the removable prosthesis is fundamental. Improvement in oral health care and oral hygiene habits is essential to promote better oral health and quality of life among the institutionalized elderly.info:eu-repo/semantics/publishedVersio

Prevalence of oral soft tissue lesions in an elderly venezuelan population

Aim: The purpose of the present study was to determine the prevalence of the oral soft tissue lesions in patients referred to the geriatric unit ?Dr. Joaquin Quintero?, National Institute of Gerontology. Study Design: 340 patients were clinically evaluated, of these 266 were institutionalized and 74 were seen at the outpatient clinic, age ranging 60 to 104 years. 212 were females and 128 males. The statistical analysis was done using the SPSS software (11.0) to a significant level of 5% (p<0.05). Results: Fifty seven percent of the studied population presented one or more oral lesions, associated to prosthetic use, trauma and tobacco consumption. Females were more affected than males. The lesions were more frequently observed between 60 to 74 years of the institutionalized group of patients of these, 34% exhibited only one oral lesion. Few cases presented up to 4 oral lesions. The most common alterations observed were: denture stomatitis, oral leukoplakia, hemangioma, oral melanotic macule, traumatic fibroma, inflammatory fibrous hyperplasia and angular cheilitis. Conclusions: The findings observed in this population are important to be considered when clinically evaluating oral soft tissue in elderly. Close follow up and systematic evaluation is required in this population

Prevalence of xerostomia in patients attending Shorish dental speciality in Sulaimani city

Objectives: The aim of this study was to investigate the prevalence of xerostomia among dental patients and explo - re the possible risk factors and symptoms associated with this condition. Study Design: The prevalence of xerostomia and its associations were investigated among patients (n=1132) who were visiting the department of oral medicine at shorish dental speciality in sulaimani city. The age range was bet - ween 10-79 years. 512 (45.2%) of participants were males and 620 (54.8%) were females. The data collected were age, sex, systemic diseases, medications and habit of smoking. Logistic regression models to estimate odds ratios and 95% confidence intervals were used to investigate the association of xerostomia with age, systemic diseases and medications and Chi Square test was also used to analyze the data. Results: Prevalence of xerostomia was 16.07%. Prevalence of xerostomia was significantly higher among females (19.51%) than males (11.91%) ( P =0.001). The most common diseases with the highest prevalence of xerostomia were psychological disorders (57.14%) followed by diabetes mellitus (53.84%), neurological disorders (40%), thyroid disorders (37.5%) and hypertension (36.48%). The most common medication with the highest prevalen - ce of xerostomia was antihistamine (66.66%) followed by psychotherapeutic medications (60%), pain medica - tions (55.88%), endocrinologic agents (51.21%), antidyslipidic agents (50%) and antihypertensive medication (38.98%). Xerostomia was significantly associated with ageing (OR: 1.02, P =0.000), systemic diseases (OR: 2.80, P =0.000) and medications (OR: 5.17, P =0.000). There was a high prevalence of reported symptoms of xerostomia and these symptoms were more prevalent among females, prevalence of xerostomia was higher in heavy smoker patients (19.48%) than non smoker patients but not significantly (16.14%) ( p = 0.44). Conclusions: There was a high prevalence of xerostomia among dental patients; xerostomia was significantly more prevalent among females and significantly associated with age, systemic diseases and medications; xerostomia adversely affects oral functions; dentist must be familial with sign and symptoms of xerostomia and can have an active role in the management of xerostomia and preventing or treating complications

The impact of a preventive and curative oral healthcare program on the prevalence and incidence of oral health problems in nursing home residents

Aims: To assess the impact of an oral healthcare program in nursing homes on the initial treatment backlog and residents' oral health stability. Materials and methods: The study is a longitudinal cohort study in nursing home residents in Flanders, Belgium, to evaluate the oral healthcare programme Gerodent. The program consisted of: (1) the introduction of an oral healthcare team, (2) oral health education, (3) the implementation of oral health guidelines and protocols, and (4) regular visits of a mobile dental team. Data were extracted from the oral health records of 381 residents from 21 nursing homes who received treatments from the mobile dental team between October 2010 and March 2014 (mean follow-up period of 22.5 months). Oral health and treatment need between baseline and follow-up were compared. Results: The mean age at baseline was 82.4 years and the mean number of consultations per resident was 3.61 during the follow-up period. The proportion of residents with an oral treatment need was reduced from 65.9% to 31.3%. Among residents with natural teeth, there was significantly lower prevalence of caries (from 70.5% at baseline to 36.5% at follow-up; p<0.001), residual roots (from 54.2% to 25.1%; p<0.001), and need for fillings (from 31.9% to 17.1%; p<0.001) or extractions (from 64.3% to 31.6%; p<0.001). In the group with partial or full dentures (n = 223), 38.1% needed a repair, rebasing or renewal of their existing dentures at baseline and the respective figure at follow-up was 9.0% (p<0.001). In terms of oral health stability, 53% of the residents had no incident restorative and prosthetic treatment need throughout the follow-up period. A lower number of natural teeth at baseline (p<0.001) and a shorter follow-up period (p = 0.002) were associated with higher chances of oral health stability. Conclusion: The oral healthcare program Gerodent significantly reduced the treatment backlog and contributed to a considerable proportion of residents being stable in terms of oral health without any incident treatment needs

Oral mucosal lesions in a Chilean elderly population: a retrospective study with a systematic review from thirteen countries

The oral examination is an essential part of the multidisciplinary medical care in elderly people. Oral mucosal lesions and normal variations of oral anatomy (OMLs) are very common in this people, but few studies have examined the frequency and prevalence of these conditions worldwide and less in Chile. The aim of this research was to evaluate the frequency of OMLs in a Chilean elderly population. It was conducted a retrospective study (Talca, Chile). Two hundred seventy-seven OMLs were classified in groups and anatomical sites. In order to contextualize our numbers, we made a systematic review using Publish or Perish software, Google Scholar and InteractiVenn. The most prevalent OMLs groups were soft tissue tumors, epithelial pathology, facial pain and neuromuscular diseases, and dermatologic diseases. The most frequent OMLs included irritation fibroma (30 patients, 10.8%), hemangioma (20, 7.2%), burning mouth syndrome (20 cases, 7.2%), oral lichen planus (12, 4.3%) and epulis fissuratum (12, 4.3%). In the systematic review, 75 OMLs were relevant and the more studied pathologies were traumatic ulcerations (11 of 15 articles), oral lichen planus (10/15), irritation fibroma, melanotic pigmentations, and recurrent aphthous stomatitis (9/10, respectively). Considering all included articles, most frequent OMLs in elderly people included denture-related stomatitis (13.3%), irritation fibroma (8.7%) and fissured tongue (6.3%). The results reflect the frequency of OMLs diagnosed in a specialized service in south of Chile and many countries around the world. These numbers will allow the establishment of preventive politics and adequacy of the clinical services

Behaviors and hygiene habits of complete denture wearers

In this study, a questionnaire was applied to patients from Ribeirão Preto Dental School, University of São Paulo, Brazil, to evaluate the hygiene methods and habits concerning the use of complete dentures, the age of dentures, and whether patients have been instructed on how to clean their dentures. The mean age of patients was 63.35 years, and most of them were females (82.08%). The results showed that 62.26% of the respondents had been using the same maxillary complete denture for more than 5 years, and 49.06% used the same mandible complete denture for more than 5 years. Of the patients interviewed, 58.49% slept with the dentures. Mechanical brushing was the most used cleaning method by the patients (100%), using water, dentifrice and toothbrush (84.91%). Most patients (51.89%) reported never having been instructed by their dentists as to how to clean their dentures. Based on the limitations of this study, it was concluded that the patients interviewed had limited knowledge about prosthetic hygiene and oral care. The method more used by patients was the mechanical method of brushing, most patients used the same complete dentures for more than 5 years and slept with the dentures.Foi realizada uma pesquisa na Faculdade de Odontologia de Ribeirão Preto - Universidade de São Paulo, por meio da aplicação de questionário, para avaliar os métodos de higiene e hábitos referentes ao uso de prótese total, idade das próteses, e se os pacientes têm sido instruídos em como limpar suas próteses. A idade média dos pacientes estudados foi 63,35 anos, a maioria (82,08%) do sexo feminino. Os resultados mostraram que 62,26% dos entrevistados usavam a mesma prótese total superior há mais de 5 anos, e 49,06% a mesma prótese total inferior. Dos pacientes entrevistados, 58,49% dormiam com as próteses. O método mais utilizado pelos pacientes foi o método mecânico de escovação (100% dos pacientes), utilizando água, pasta e escova de dente (84,91%). A maioria dos pacientes (51,89%) relatou nunca ter sido orientado pelos dentistas de como higienizar as próteses. Baseado nas limitações deste estudo, concluiu-se que os pacientes entrevistados tinham conhecimento limitado sobre higiene protética e cuidados bucais. O método de higiene mais utilizado foi a escovação da prótese, a maioria dos pacientes usavam a mesma prótese total há mais de cinco anos e dormiam com as próteses

Longitudinal Study on Oral Health in Subjects with Alzheimer's Disease

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111087/1/j.1532-5415.1994.tb06074.x.pd